It’s the time of year that most parents of elementary school children dread. Between October and April (depending on where you live), one of the most common childhood illnesses seems to show its ugly face all too often. It’s 4 in the morning, and your child wakes up with a fever (usually on Fridays) complaining of a sore throat, headache, and stomach ache. As you give them Advil, you take a small penlight and try to look at the back of their throat to see if the telltale white specks of strep are visible. If they do have strep, you’re likely to catch a whiff of that stagnant smell—something beyond morning breath and poor dental hygiene—that’s another common indicator that strep throat is now floating around your home. Yikes!
According to the CDC, strep throat infections affect well over half of all school-age children each year. It is as common as, or even more so than, the common cold, and if left untreated, it can be potentially dangerous. In recent years, as doctors have become more cautious about prescribing antibiotics unnecessarily, many parents (especially those who have been through this before) feel caught in the middle. If it’s strep throat, it’s definitely worth taking your child to the doctor, as you’ll get a prescription and a diagnosis. However, if it’s not strep, you not only waste a co-pay, but you also risk picking up more germs while waiting at the pediatrician’s office. Not to mention, you’re left to worry until the fever breaks. Being able to spot the signs of strep can be helpful, but keep in mind that as children get older and experience strep more frequently, their symptoms may become milder, and strep can sometimes go undetected unless swabbed by a physician.
Common Signs and Symptoms of Strep Throat
Signs of strep throat include a headache (mostly from the fever), stomachache, white pus-filled pustules in the back of the throat, swollen or enlarged glands, foul-smelling breath (hard to explain, but when you smell it, you’ll know), vomiting, and cramps. Some kids develop a form of strep called scarlet fever, which sounds scarier than it is. Scarlet fever is simply a strep infection combined with a rash of flat red spots that can cover the body. The rash is painless and looks ominous, but there’s no need to worry. Some kids may also complain about back pain or experience flu-like aches and pains without the other symptoms. Older children, especially, may only have a fever and headache. Fevers with strep can range from 99.8 to 105.6 degrees, and according to the American Academy of Pediatrics, this doesn’t indicate the severity of the infection. An infection is largely based on your child’s immune system and internal thermostat—every child reacts differently.
Practical advice for parents dealing with illness is essential. First of all, talk to your child’s teacher. They are likely aware if a classmate has been recently diagnosed with strep or another virus. The school nurse is also usually informed about how many kids are absent and should have a good idea of what they have. If your child has been around someone with strep, chances are they’ve caught it. Strep throat spreads through saliva, mucus, sneezing, and other germs that are abundant in classrooms. If other children in your home have had strep in the past week, again, it’s likely that the infection is spreading within your household. The incubation period is about 1 to 5 days from exposure. Plus, it would be too easy if all your kids got sick at once and you could take them to one doctor’s visit and pick up all their prescriptions at the same time! If you’re like me, you might be tempted to share medications to treat them all. Trust me, not only does it not work, but it can alter the results of a rapid strep test. Antibiotics will not prevent strep throat, and when a child with a virus is given antibiotics, they may develop a rash. Many pediatricians (including mine) will automatically call in more prescriptions if one of your kids has had strep and another ends up with a fever within 5 days. Bless their hearts! It’s worth calling your doctor to ask.
The sooner you start antibiotics, the sooner your child will get well. With strep throat, children typically lose their fever and can return to school within 24 hours of their first dose. If you decide to wait a day or two, the infection can worsen and may take longer to respond to antibiotics. If you suspect strep for any of the reasons mentioned above, it’s best to take your child to the doctor and have their throat cultured. It’s painless and quick, providing a clear diagnosis.
If this year seems like your child is catching every virus or bug going around, it can certainly cause worry and frustration. You know it’s a rough year when you keep the thermometer in your purse at all times. This is typical with school-age kids, and it’s simply a sign they’re building their immune systems. If you’re really concerned, be honest with your pediatrician and, from experience, I suggest requesting a spot mononucleosis test. Mononucleosis is becoming more common in young children (under third grade) and can be a contributing factor to frequent illnesses. Johns Hopkins University published a study a few years ago showing that mono is rapidly becoming an elementary school illness. Children with mono are prone to more frequent illnesses, swollen glands, repeated infections, and ongoing fatigue and weakness. Many pediatricians don’t test for it routinely, so if yours doesn’t, make sure to request it, especially if your child is sick often.
Strep throat can be serious, potentially leading to internal organ damage or, in rare cases, hospitalization. Each year, pediatricians find it harder to treat as strep becomes resistant to some common antibiotics. One way we can help is by getting our children checked as soon as we suspect strep, keeping them home from school when they’re sick, and ensuring they finish the entire round of prescribed antibiotics if they are diagnosed with strep. If your child is diagnosed, sharing the information with teachers or caregivers helps other parents stay informed. Handwashing is essential, and teaching our children about the spread of germs can make them more effective in preventing viruses like strep. As a parent, you never want your child to be sick, but unfortunately, that’s unrealistic. If they have strep throat—whether it’s the first time or the tenth—rest assured, they’ll be feeling much better within a few days. Even on Friday night at 4 a.m., when you feel most helpless, it’s best to remain calm, wait until daylight, and take them to a walk-in clinic for a strep test. Chances are, if it is strep, they’ll be bouncing back off the walls by Sunday and back at school on Monday!
